- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04618809
Improving the Approach to and Management of the Older Patient With Metastatic Gastric Cancer
Study Overview
Status
Conditions
Detailed Description
Older oncology patients pose a significant treatment challenge due to poor chemotherapy tolerance as a result of underlying co-morbidities, lack of social support, and diminished functional reserve. Oncologists are faced with the challenge of differentiating between patients that can and cannot tolerate chemotherapy, and tailoring therapy to the patient's biologic rather than chronologic age.
A significant challenge that surrounds the treatment of the older metastatic gastric cancer (mGC) patient in particular, lies in the lack of evidence based clinical data to guide the oncologist in determination of a treatment plan. This is a result of under representation of older patients in clinical trials. Due to these challenges, a thorough evaluation of the older patient is recommended prior to initiation of anti-cancer therapy.
The purpose of this research study is to enhance the care of the older mGC patient by increasing awareness among oncology providers of the unique aspects of care required for older patients. The goal of the study is to educate providers on the utility of geriatric assessment in guiding therapy of older metastatic gastric cancer patients. The investigators will also assess the feasibility and benefit of incorporating geriatric self-assessments into clinical practice. The study will include four phases:
- Needs assessments - to understand the population of older gastric cancer patients seen in routine practice at community and academic centers, and assess their treatment approach.
- Educational programming about management of older metastatic gastric cancer patients, and geriatric assessment of these patients.
- Active testing of the use of geriatric assessment in clinical practice, including an exploratory analysis to evaluate the use of fitness trackers for evaluation of functional status.
- Short-term follow-up chart reviews (2-3 months post intervention) to assess for actual implementation of recommended interventions identified by the geriatric assessment.
The ultimate goal is to expand this educational intervention to other oncology practices beyond those participating in this study, and for all older cancer patients regardless of their disease site. During this study period we will identify the specific gaps that exist in each practice for the care of older patients with mGC. This information is crucial to understand the needs of this patient population and will inform future trials with possible intervention. The second phase of our study will expose the practices to the use of a geriatric assessment through a patient's self-assessment tool and demonstrate its feasibility. Our hope is that all involved practices will find benefit from incorporating a geriatric assessment into their practice and will continue to use it in the future.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Pennsylvania
-
Philadelphia, Pennsylvania, United States, 19111
- Recruiting
- Fox Chase Cancer Center
-
Philadelphia, Pennsylvania, United States, 19140
- Not yet recruiting
- Temple University Hospital
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Ability to read and understand English, ability to sign consent, and complete a self-assessment evaluation.
- Evidence of mGC (mGE junction cancer allowed). Patients can be enrolled at any stage of their treatment or disease course.
- Ongoing active therapy for mGC. Patients can be treated with any type of therapy including chemotherapy, immunotherapy or Her-2 targeted therapy.
- Life expectancy ≥3 months.
Exclusion Criteria:
- ≤69 years old.
- Inability to read and understand English.
- No evidence of mGC.
- Not on active therapy.
- Life expectancy <3 months.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Health Services Research
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Provider Didactic Intervention
|
This session will include an overview of the approach to and management of older mGC patients patients through a case-based presentation.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of geriatric abnormalities detected. (Tool used: Comprehensive Geriatric Assessment)
Time Frame: 18 Months
|
Investigators will test the proportions of patients having at least one abnormality detected by the Comprehensive Geriatric Assessment that was missed in the standard clinical assessment compared to a null-hypothesis rate of 5%. The Comprehensive Geriatric Assessment includes the following scales: Eastern Cooperative Oncology Group Performance Status, Self-rated Performance Status, Katz Activities of Daily Living scale, Lawton Instrumental Activities of Daily Live Scale, Timed Up and Go, Number of Falls in past 6 months, Medical Social Support Scale, Geriatric Depression Scale, National Comprehensive Cancer Center Distress Thermometer, Blessed Orientation Memory Concentration Scale, Charlson Comorbidity Index, Body Mass index,Mini Nutritional Assessment, Cancer and Aging Research Group Chemotherapy Toxicity Prediction Calculator, Comprehensive Score for Financial Toxicity - Functional Assessment of Chronic Illness Therapy scale |
18 Months
|
Percentage of treatment plan changes. (Count # of treatment changes 2-3 months after comprehensive geriatric assessment. Site coordinators will complete follow-up chart review of each patient to see what, if any, changes were made)
Time Frame: 18 months
|
Investigators will assess the percentage of physician reported cases whose treatment plan was modified due to responses on the Comprehensive Geriatric Assessment.
|
18 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Provider perception (Review of Geriatric Assessment Questionnaire)
Time Frame: 18 months
|
Measurement of provider perception of the efficacy and feasibility of the didactic educational session via questionnaire
|
18 months
|
Fitbit assessed functional status. Fitbit data: step count
Time Frame: 18 months
|
We aim to determine the feasibility of using fitbits in this patient population and evaluate the correlation between step count, physician recorded performance status, and scores on functional assessment in the comprehensive geriatric assessment. We will compare data collected from the FitBit to both the physician-reported and CGA-identified functional status (Timed Up and Go, Activities of Daily Living, Instrumental Activities of Daily Living, and number of falls in the past 6 months) in each patient. |
18 months
|
Fitbit assessed functional status. Fitbit data: distance logged
Time Frame: 18 months
|
We aim to determine the feasibility of using fitbits in this patient population and evaluate the correlation between distance logged, physician recorded performance status, and scores on functional assessment in the comprehensive geriatric assessment. We will compare data collected from the FitBit to both the physician-reported and CGA-identified functional status (Timed Up and Go, Activities of Daily Living, Instrumental Activities of Daily Living, and number of falls in the past 6 months) in each patient. |
18 months
|
Fitbit assessed functional status. Fitbit data: moderately active, lightly active, and sedentary minute categorization.
Time Frame: 18 months
|
We aim to determine the feasibility of using fitbits in this patient population and evaluate the correlation between moderately active, lightly active, and sedentary minute categorization, physician recorded performance status, and scores on functional assessment in the comprehensive geriatric assessment. We will compare data collected from the FitBit to both the physician-reported and CGA-identified functional status (Timed Up and Go, Activities of Daily Living, Instrumental Activities of Daily Living, and number of falls in the past 6 months) in each patient. |
18 months
|
Fitbit assessed functional status. Fitbit data: floors climbed
Time Frame: 18 months
|
We aim to determine the feasibility of using fitbits in this patient population and evaluate the correlation between floors climbed, physician recorded performance status, and scores on functional assessment in the comprehensive geriatric assessment. We will compare data collected from the FitBit to both the physician-reported and CGA-identified functional status (Timed Up and Go, Activities of Daily Living, Instrumental Activities of Daily Living, and number of falls in the past 6 months) in each patient. |
18 months
|
Fitbit assessed functional status. Fitbit data: calories burned
Time Frame: 18 months
|
We aim to determine the feasibility of using fitbits in this patient population and evaluate the correlation between calories burned, physician recorded performance status, and scores on functional assessment in the comprehensive geriatric assessment. We will compare data collected from the FitBit to both the physician-reported and CGA-identified functional status (Timed Up and Go, Activities of Daily Living, Instrumental Activities of Daily Living, and number of falls in the past 6 months) in each patient. |
18 months
|
Fitbit assessed functional status. Fitbit data: heart rate
Time Frame: 18 months
|
We aim to determine the feasibility of using fitbits in this patient population and evaluate the correlation between heart rate, physician recorded performance status, and scores on functional assessment in the comprehensive geriatric assessment. We will compare data collected from the FitBit to both the physician-reported and CGA-identified functional status (Timed Up and Go, Activities of Daily Living, Instrumental Activities of Daily Living, and number of falls in the past 6 months) in each patient. |
18 months
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 20-8006
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Metastatic Gastric Cancer
-
Memorial Sloan Kettering Cancer CenterRecruitingMetastatic Gastric Adenocarcinoma | Metastatic Gastroesophageal Junction Adenocarcinoma | Unresectable Gastric Adenocarcinoma | Unresectable Gastroesophageal Junction Adenocarcinoma | Metastatic Gastric Cancer | Unresectable Esophageal Cancer | Metastatic Esophageal Carcinoma | Metastatic Gastric... and other conditionsUnited States
-
City of Hope Medical CenterRecruitingGastric Cancer | Gastric Adenocarcinoma | Gastric Cancer Stage IV | Gastric Neoplasm | Gastric Cancer Metastatic to Lung | Gastric Cancer Stage | Gastric Cancer Metastatic to Liver | Gastric Cancer Stage III | Gastric Cancer Stage II | Gastric Lesion | Gastric Cancer in Situ | Gastric Cancer Stage IIIB | Gastric... and other conditionsUnited States, Japan
-
Royal Marsden NHS Foundation TrustRecruitingMetastatic Gastric Cancer | Metastatic Esophageal CancerUnited Kingdom
-
Erasmus Medical CenterSanofiWithdrawnMetastatic Lung Cancer | Metastatic Breast Cancer | Metastatic Gastric CancerNetherlands
-
Amsterdam UMC, location VUmcAstraZenecaRecruitingBreast Cancer | Gastric Cancer | Metastatic Breast Cancer | HER2-positive Breast Cancer | HER2-positive Gastric Cancer | Metastatic Gastric CancerNetherlands
-
Chia Tai Tianqing Pharmaceutical Group Co., Ltd.CompletedMetastatic Breast Cancer | Metastatic Gastric CancerChina
-
Huashan HospitalSeattle Integrative Cancer CenterUnknownMetastatic Gastric Cancer | Locally Advanced Gastric CancerChina, United States
-
Gruppo Italiano per lo studio dei Carcinomi dell...Regione LombardiaTerminatedMetastatic Gastric Cancer | Locally Advanced Unresectable Gastric CancerItaly
-
Astellas Pharma Global Development, Inc.AvailableMetastatic Gastroesophageal Junction (GEJ) Adenocarcinoma | Locally Advanced Unresectable Gastroesophageal Junction (GEJ) Adenocarcinoma Cancer | Locally Advanced Unresectable Gastric Adenocarcinoma Cancer | Metastatic Gastric Adenocarcinoma CancerUnited States
-
Shanghai Miracogen Inc.RecruitingAdvanced Solid Tumors | Advanced or Metastatic Gastric Cancer | Advanced or Metastatic Gastroesophageal Junction CancerUnited States
Clinical Trials on Didactic Session
-
Fox Chase Cancer CenterPfizer; National Comprehensive Cancer NetworkCompletedMetastatic Breast CancerUnited States
-
Henry Ford Health SystemCompletedHealthyUnited States
-
Boston Medical CenterCompletedCirrhosis | AscitesUnited States
-
Agencia Lain EntralgoInstituto de Salud Carlos III; Fundación de Investigación Biomédica - Hospital... and other collaboratorsCompletedCardiovascular Diseases | ObesitySpain
-
Obafemi Awolowo University Teaching HospitalMemorial Sloan Kettering Cancer CenterRecruiting
-
Universidad de la SabanaNot yet recruitingTelemedicine | Newborn Morbidity | Simulation Training | Assessment, SelfColombia
-
University of Illinois at ChicagoCompleted
-
Case Western Reserve UniversityNational Institute of Dental and Craniofacial Research (NIDCR)Completed
-
University of RochesterCompleted
-
International Institute of Rescue Research and...Unknown